Immunonutrition in major oncologic head and neck surgery: Analysis of complications, plasmatic equilibrium, and costs

Ascoli, Alessandro; Missale, Francesco; Giordano, Giorgio-Gregory; Vallin, Alberto; Gradaschi, Raffaella; Guiddo, Erica; Schenone, G.; Sukkar, Samir Giuseppe; Copello, F; Parrinello, Giampiero; Iandelli, Andrea; Peretti, Giorgio; Marchi, Filippo

doi:10.1002/hed.27270

Cited by 2 publications

(2 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, percutaneous gastrostomy is an additional procedure that adds to the overall cost of the surgical treatment being a significant financial burden depending on the healthcare system 24 . From this perspective, future studies should also focus on the potential benefit of our model in terms of cost, in order to include an economic analysis in the decision‐making process 25 …”

Section: Discussionmentioning

confidence: 99%

“…24 From this perspective, future studies should also focus on the potential benefit of our model in terms of cost, in order to include an economic analysis in the decision-making process. 25 Previous studies were mainly focused on developing prediction models to identify patients who need prophylactic gastrostomy insertion before undergoing RT. In this context, the performance metrics of our model are consistent with the ones found in the literature for non-surgical patients.…”

Section: Variablementioning

confidence: 99%

See 1 more Smart Citation

Predicting the need for prophylactic gastrostomy in major head and neck cancer surgery: The PEG score

Sampieri,

Costantino,

Giordano

et al. 2023

Head & Neck

Self Cite

View full text Add to dashboard Cite

BackgroundTo elaborate a preoperative score to predict the necessity of enteral nutrition at 28 days postoperatively in patients undergoing head and neck surgery.MethodsA total of 424 patients with oral cavity, oropharyngeal, laryngeal, and hypopharyngeal carcinoma were retrospectively enrolled and analyzed to identify preoperative predictors of prolonged postsurgical enteral feeding which were used to create a prediction model with an easy‐to‐use nomogram.ResultsFive preoperative variables (body mass index, previous radiotherapy, preoperative dysphagia, type of surgery, flap reconstruction) were found to be independent predictive factors and were used to create a prediction model named PEG score together with the related nomogram. Accuracy, F1, and the area under the curve (AUC) were 0.74, 0.83, and 0.74. Different decision thresholds can be used to vary the sensitivity and specificity.ConclusionsThe PEG score showed high prediction performances for modeling the need for enteral nutrition at 28 days postoperatively. Prospective studies are needed to define a personalized nutrition protocol.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Variablementioning

confidence: 99%

Predicting the need for prophylactic gastrostomy in major head and neck cancer surgery: The PEG score

Sampieri,

Costantino,

Giordano

et al. 2023

Head & Neck

Self Cite

View full text Add to dashboard Cite

show abstract

The role of prehabilitation in HNSCC patients treated with chemoradiotherapy

Gili,

Gianluca,

Paolo

et al. 2024

Support Care Cancer

View full text Add to dashboard Cite

Background Radiotherapy (RT) is used in head and neck squamous cell carcinoma (HNSCC) with excellent effectiveness, but it is burdened by important side effects, which may negatively impact patients’ quality of life (QoL). In particular when associated with chemotherapy (CT), that has a radiosensitising effect (and its own toxicities), it is responsible for several adverse events, causing social discomfort and lower QoL, in patients who are already experiencing several tumor-related discomforts. Prehabilitation is a healthcare intervention consisting of several specialist visits prior to the start of treatment, with the aim of improving the patient’s health status, resolving symptoms that interfere with treatment and impact QoL, and finally to better avoid or overcome complications. Of all cancer patients, HNSCC patients are among those who could benefit most from prehabilitation, both because of the high number of symptoms and toxicities and their difficult management. Despite this and the emerging data, prehabilitation is not often considered for the majority of patients undergoing (C)RT. In this review, we tried to understand what are the main areas in which interventions can be made prior to the (C)RT start, the possible side effects of the treatment, the effectiveness in their prevention and management, and the impact that prehabilitation may have in adherence to therapy and on the principal survival outcomes, providing important guidance for the planning of future studies. Evidences and conclusions Although there is no strong data evaluating multidisciplinary prehabilitation strategies, evidence shows that optimizing the patient’s health status and preventing possible complications improve the QoL, reduce the incidence and severity of adverse events, and improve treatment adherence. While cardiology prehabilitation is of paramount importance for all patients undergoing concomitant CRT in the prevention of possible side effects, the remaining interventions are useful independently of the type of treatment proposed. Geriatricians have a key role in both elderly patients and younger patients characterized by many comorbidities to comprehensively assess health status and indicate which treatment may be the best in terms of risk/benefit ratio. Collaboration between nutritionists and phoniatrics, on the other hand, ensures adequate nutritional intake for the patient, where possible orally. This is because optimizing both body weight and muscle mass and qualities has been shown to impact key survival outcomes. Finally, HNSCC patients have the second highest suicide rate, and the disease has side effects such as pain, dysfiguration, and sialorrhea that can reduce the patient’s social life and create shame and embarrassment: A psychological intake, in addition to the usefulness to the patient, can also provide current support to caregivers and family members. Therefore clinicians must define a personalized pathway for patients, considering the characteristics of the disease and the type of treatment proposed, to optimize health status and prevent possible side effects while also improving QoL and treatment adherence.

show abstract

Immunonutrition in major oncologic head and neck surgery: Analysis of complications, plasmatic equilibrium, and costs

Cited by 2 publications

References 65 publications

Predicting the need for prophylactic gastrostomy in major head and neck cancer surgery: The PEG score

Predicting the need for prophylactic gastrostomy in major head and neck cancer surgery: The PEG score

The role of prehabilitation in HNSCC patients treated with chemoradiotherapy

Contact Info

Product

Resources

About